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BACKGROUND: Skin and soft tissue infections (SSTIs) are commonly encountered in clinical practice. Point-of-care ultrasound (POCUS) is becoming an increasingly valuable tool in hospital medicine, especially with advancements in ultrasound technology that make it easier to perform. POCUS can augment the history and physical exam in patients with suspected SSTIs. POCUS can detect deeper infections, such as abscesses, and expedite time to surgical debridement for life-threatening infections such as necrotizing fasciitis (NF). OBJECTIVES: This review provides an introduction on how to perform and interpret a skin and soft tissue POCUS exam, the key sonographic findings for SSTIs, and how to incorporate these findings into clinical reasoning and management. METHODS: SSTI POCUS literature was reviewed using PubMed. All relevant studies with a defined protocol and reported sensitivity and specificity pertaining to the use of POCUS to diagnose SSTIs in adults were included. The authors provide additional input based on their ultrasound expertise and clinical experience. RESULTS: A total of seven studies met the criteria to be included in this review. CONCLUSIONS: Soft tissue POCUS is a valuable tool for hospitalists to improve diagnostic accuracy and patient care when assessing suspected SSTIs. Access to equipment, POCUS training, and experience are barriers to widespread use. However, performing a soft tissue POCUS exam is straightforward. It requires less training compared to other POCUS exams, and it has notable potential for routine future practice in the evaluation and management of suspected SSTIs and other dermatologic conditions.
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To adjust to stressful environments, people seek information. Here, we show that in response to stressful public and private events the high-level features of information people seek online alter, reflecting their motives for seeking knowledge. We first show that when people want information to guide action they selectively ask "How" questions. Next, we reveal that "How" searches submitted to Google increased dramatically during the pandemic (controlling for search volume). Strikingly, the proportion of these searches predicted weekly self-reported stress of ~ 17K individuals. To rule out third factors we manipulate stress and find that "How" searches increase in response to stressful, personal, events. The findings suggest that under stress people ask questions to guide action, and mental state is reflected in features that tap into why people seek information rather than the topics they search for. Tracking such features may provide clues regrading population stress levels.
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Internet , Estresse Psicológico , Humanos , Estresse Psicológico/psicologia , Comportamento de Busca de Informação/fisiologia , COVID-19/psicologia , COVID-19/epidemiologia , PandemiasRESUMO
The ability to tame high-energy intermediates is important for synthetic chemistry, enabling the construction of complex molecules and propelling advances in the field of synthesis. Along these lines, carbenes and carbenoid intermediates are particularly attractive, but often unknown, high-energy intermediates1,2. Classical methods to access metal carbene intermediates exploit two-electron chemistry to form the carbon-metal bond. However, these methods are usually prohibitive because of reagent safety concerns, limiting their broad implementation in synthesis3-6. Mechanistically, an alternative approach to carbene intermediates that could circumvent these pitfalls would involve two single-electron steps: radical addition to metal to forge the initial carbon-metal bond followed by redox-promoted α-elimination to yield the desired metal carbene intermediate. Here we realize this strategy through a metallaphotoredox platform that exploits iron carbene reactivity using readily available chemical feedstocks as radical sources and α-elimination from six classes of previously underexploited leaving groups. These discoveries permit cyclopropanation and σ-bond insertion into N-H, S-H and P-H bonds from abundant and bench-stable carboxylic acids, amino acids and alcohols, thereby providing a general solution to the challenge of carbene-mediated chemical diversification.
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Álcoois , Aminoácidos , Ácidos Carboxílicos , Técnicas de Química Sintética , Ferro , Metano , Fotoquímica , Álcoois/química , Aminoácidos/química , Carbono/química , Ácidos Carboxílicos/química , Catálise , Ciclopropanos/química , Ciclopropanos/síntese química , Ferro/química , Metano/análogos & derivados , Metano/química , Oxirredução , Fotoquímica/métodos , Técnicas de Química Sintética/métodos , ElétronsRESUMO
We present methods for making and testing the membrane biophysics of model lipid droplets (LDs). Methods are described for imaging LDs ranging in size from 0.1 to 40 µm in diameter with high-resolution microscopy and spectroscopy. With known LD compositions, membrane binding, sorting, diffusion, and tension were measured via fluorescence correlation spectroscopy (FCS), fluorescence recovery after photobleaching (FRAP), fluorescence lifetime imaging microscopy (FLIM), atomic force microscopy (AFM), and imaging flow cytometry. Additionally, a custom, small-volume pendant droplet tensiometer is described and used to measure the association of phospholipids to the LD surface. These complementary, cross-validating methods of measuring LD membrane behavior reveal the interplay of biophysical processes on lipid droplet monolayers.
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Gotículas Lipídicas , Gotículas Lipídicas/metabolismo , Gotículas Lipídicas/química , Microscopia de Força Atômica/métodos , Microscopia de Fluorescência/métodos , Recuperação de Fluorescência Após Fotodegradação/métodos , Humanos , Citometria de Fluxo/métodos , Espectrometria de Fluorescência/métodosRESUMO
Visual observation data collected by protected species observers (PSOs) is required per regulations stipulated in Notices to Lessees (NTLs) and geophysical survey Permits (Form BOEM-0328) issued to seismic operators in the Gulf of Mexico (GOM). Here, data collected by certified and trained PSOs during seismic surveys conducted between 2002-2015 were compiled and analyzed to assess utility in assessing marine mammal responses to seismic noise and effectiveness of required mitigation measures. A total of 3,886 agency-required bi-weekly PSO Effort and Sightings reports were analyzed comprising 598,319 hours of PSO visual effort and 15,117 visual sighting records of marine mammals. The observed closest point of approach (CPA) distance was statistically compared across five species groupings for four airgun activity levels (full, minimum source, ramp up, silent). Whale and dolphin detections were significantly farther from airgun array locations during full power operations versus silence, indicating some avoidance response to full-power operations. Dolphin CPA distances were also significantly farther from airguns operating at minimum source than silence. Blackfish were observed significantly farther from the airgun array during ramp up versus both full and minimum source activities. Blackfish were observed significantly closer to the airgun array during silent activities versus at full, minimum source, and ramp up activities. Beaked whales had the largest mean CPA for detection distance compared to all other species groups. Detection distances for beaked whales were not significantly differences between full and silent operations; however, the sample size was very low. Overall results are consistent with other studies indicating that marine mammals may avoid exposure to airgun sounds based on observed distance from the seismic source during specified source activities. There was geographic variability in sighting rates associated with specific areas of interest within the GOM. This study demonstrates that agency required PSO reports provide a robust and useful data set applicable to impact assessments; management, policy and regulatory decision making; and qualitative input for regional scientific, stock assessment and abundance studies. However, several improvements in content and consistency would facilitate finer-scale analysis of some topics (e.g., effort associated with specific activities, observer biases, sound field estimation) and support statistical comparisons that could provide further insight into marine mammal responses and mitigation efficacy.
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Acústica , Golfinhos , Animais , Golfo do México , Som , Baleias/fisiologiaRESUMO
Heteroarenes are ubiquitous motifs in bioactive molecules, conferring favourable physical properties when compared to their arene counterparts1-3. In particular, semisaturated heteroarenes possess attractive solubility properties and a higher fraction of sp3 carbons, which can improve binding affinity and specificity. However, these desirable structures remain rare owing to limitations in current synthetic methods4-6. Indeed, semisaturated heterocycles are laboriously prepared by means of non-modular fit-for-purpose syntheses, which decrease throughput, limit chemical diversity and preclude their inclusion in many hit-to-lead campaigns7-10. Herein, we describe a more intuitive and modular couple-close approach to build semisaturated ring systems from dual radical precursors. This platform merges metallaphotoredox C(sp2)-C(sp3) cross-coupling with intramolecular Minisci-type radical cyclization to fuse abundant heteroaryl halides with simple bifunctional feedstocks, which serve as the diradical synthons, to rapidly assemble a variety of spirocyclic, bridged and substituted saturated ring types that would be extremely difficult to make by conventional methods. The broad availability of the requisite feedstock materials allows sampling of regions of underexplored chemical space. Reagent-controlled radical generation leads to a highly regioselective and stereospecific annulation that can be used for the late-stage functionalization of pharmaceutical scaffolds, replacing lengthy de novo syntheses.
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Carbono , Técnicas de Química Sintética , Compostos Heterocíclicos com 1 Anel , Preparações Farmacêuticas , Carbono/química , Ciclização , Compostos Heterocíclicos com 1 Anel/síntese química , Compostos Heterocíclicos com 1 Anel/química , Solubilidade , Oxirredução , Fotoquímica , Preparações Farmacêuticas/síntese química , Preparações Farmacêuticas/química , Técnicas de Química Sintética/métodosRESUMO
The Consolidated Standards of Reporting Trials extension for Artificial Intelligence interventions (CONSORT-AI) was published in September 2020. Since its publication, several randomised controlled trials (RCTs) of AI interventions have been published but their completeness and transparency of reporting is unknown. This systematic review assesses the completeness of reporting of AI RCTs following publication of CONSORT-AI and provides a comprehensive summary of RCTs published in recent years. 65 RCTs were identified, mostly conducted in China (37%) and USA (18%). Median concordance with CONSORT-AI reporting was 90% (IQR 77-94%), although only 10 RCTs explicitly reported its use. Several items were consistently under-reported, including algorithm version, accessibility of the AI intervention or code, and references to a study protocol. Only 3 of 52 included journals explicitly endorsed or mandated CONSORT-AI. Despite a generally high concordance amongst recent AI RCTs, some AI-specific considerations remain systematically poorly reported. Further encouragement of CONSORT-AI adoption by journals and funders may enable more complete adoption of the full CONSORT-AI guidelines.
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Inteligência Artificial , Ensaios Clínicos Controlados Aleatórios como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Humanos , Guias como Assunto , Projetos de Pesquisa/normas , Relatório de Pesquisa/normas , ChinaRESUMO
Demyelination in the central nervous system (CNS) resulting from injury or disease can cause loss of nerve function and paralysis. Cell therapies intended to promote remyelination of axons are a promising avenue of treatment, with mesenchymal stromal cells (MSCs) a prominent candidate. We have previously demonstrated that MSCs derived from human olfactory mucosa (hOM-MSCs) promote myelination to a greater extent than bone marrow-derived MSCs (hBM-MSCs). However, hOM-MSCs were developed using methods and materials that were not good manufacturing practice (GMP)-compliant. Before considering these cells for clinical use, it is necessary to develop a method for their isolation and expansion that is readily adaptable to a GMP-compliant environment. We demonstrate here that hOM-MSCs can be derived without enzymatic tissue digestion or cell sorting and without culture antibiotics. They grow readily in GMP-compliant media and express typical MSC surface markers. They robustly produce CXCL12 (a key secretory factor in promoting myelination) and are pro-myelinating in in vitro rodent CNS cultures. GMP-compliant hOM-MSCs are comparable in this respect to those grown in non-GMP conditions. However, when assessed in an in vivo model of demyelinating disease (experimental autoimmune encephalitis, EAE), they do not significantly improve disease scores compared with controls, indicating further pre-clinical evaluation is necessary before their advancement to clinical trials.
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Antibacterianos , Células-Tronco Mesenquimais , Humanos , Técnicas de Cultura , Axônios , Transporte BiológicoRESUMO
OBJECTIVE: To assess the relationships between (1) environmental and demographic factors and executive function (EF) in preschool children with congenital heart disease (CHD) and controls and (2) clinical and surgical risk factors and EF in preschool children with CHD. STUDY DESIGN: At 4-6 years of age, parents of children with CHD (n = 51) and controls (n = 124) completed the Behavior Rating Inventory of Executive Function, Preschool Version questionnaire and the Cognitively Stimulating Parenting Scale (CSPS). Multivariable general linear modeling assessed the relationship between Behavior Rating Inventory of Executive Function, Preschool Version composite scores (Inhibitory Self-Control Index [ISCI], Flexibility Index [FI], and Emergent Metacognition Index [EMI]) and group (CHD/control), sex, age at assessment, gestational age, Index of Multiple Deprivation, and CSPS scores. The relationships between CHD type, surgical factors, and brain magnetic resonance imaging injury rating and ISCI, FI, and EMI scores were assessed. RESULTS: The presence of CHD, age at assessment, sex, and Index of Multiple Deprivation were not associated with EF scores. Lower gestational age was associated with greater ISCI and FI scores, and age at assessment was associated with lower FI scores. Group significantly moderated the relationship between CSPS and EF, such that CSPS significantly predicted EF in children with CHD (ISCI: P = .0004; FI: P = .0015; EMI: P = .0004) but not controls (ISCI: P = .2727; FI: P = .6185; EMI: P = .3332). There were no significant relationships between EF scores and surgical factors, CHD type, or brain magnetic resonance imaging injury rating. CONCLUSIONS: Supporting parents to provide a cognitively stimulating home environment may improve EF in children with CHD. The home and parenting environment should be considered when designing intervention studies aimed at improving EF in this patient group.
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Função Executiva , Cardiopatias Congênitas , Humanos , Pré-Escolar , Ambiente Domiciliar , Poder Familiar , Pais , Cardiopatias Congênitas/complicaçõesRESUMO
OBJECTIVE: To examine the relationship between perioperative brain injury and neurodevelopment during early childhood in patients with severe congenital heart disease (CHD). STUDY DESIGN: One hundred and seventy children with CHD and born at term who required cardiopulmonary bypass surgery in the first 6 weeks after birth were recruited from 3 European centers and underwent preoperative and postoperative brain MRIs. Uniform description of imaging findings was performed and an overall brain injury score was created, based on the sum of the worst preoperative or postoperative brain injury subscores. Motor and cognitive outcomes were assessed with the Bayley Scales of Infant and Toddler Development Third Edition at 12 to 30 months of age. The relationship between brain injury score and clinical outcome was assessed using multiple linear regression analysis, adjusting for CHD severity, length of hospital stay (LOS), socioeconomic status (SES), and age at follow-up. RESULTS: Neither the overall brain injury score nor any of the brain injury subscores correlated with motor or cognitive outcome. The number of preoperative white matter lesions was significantly associated with gross motor outcome after correction for multiple testing (P = .013, ß = -0.50). SES was independently associated with cognitive outcome (P < .001, ß = 0.26), and LOS with motor outcome (P < .001, ß = -0.35). CONCLUSION: Preoperative white matter lesions appear to be the most predictive MRI marker for adverse early childhood gross motor outcome in this large European cohort of infants with severe CHD. LOS as a marker of disease severity, and SES influence outcome and future intervention trials need to address these risk factors.
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Lesões Encefálicas , Cardiopatias Congênitas , Lactente , Humanos , Pré-Escolar , Encéfalo/patologia , Lesões Encefálicas/etiologia , Lesões Encefálicas/patologia , Cardiopatias Congênitas/cirurgia , Cardiopatias Congênitas/complicações , Imageamento por Ressonância Magnética , Fatores de RiscoRESUMO
The National Center for Biotechnology Information (NCBI) provides online information resources for biology, including the GenBank® nucleic acid sequence database and the PubMed® database of citations and abstracts published in life science journals. NCBI provides search and retrieval operations for most of these data from 35 distinct databases. The E-utilities serve as the programming interface for most of these databases. Resources receiving significant updates in the past year include PubMed, PMC, Bookshelf, SciENcv, the NIH Comparative Genomics Resource (CGR), NCBI Virus, SRA, RefSeq, foreign contamination screening tools, Taxonomy, iCn3D, ClinVar, GTR, MedGen, dbSNP, ALFA, ClinicalTrials.gov, Pathogen Detection, antimicrobial resistance resources, and PubChem. These resources can be accessed through the NCBI home page at https://www.ncbi.nlm.nih.gov.
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Bases de Dados Genéticas , National Library of Medicine (U.S.) , Biotecnologia/instrumentação , Bases de Dados de Ácidos Nucleicos , Internet , Estados UnidosRESUMO
OBJECTIVE: Transesophageal echocardiography (TEE) is becoming increasingly utilized by emergency medicine providers during cardiac arrest. Intra-arrest, TEE confers several benefits including shorter pauses in chest compressions and direct visualization of cardiac compressions. Many ultrasound probe manufacturers recommend against performing defibrillation with the TEE probe in the mid-esophagus for fear of causing esophageal injury or damage to the probe, however no literature exists that has investigated this concern. To assess this, we performed cardiopulmonary resuscitation (CPR) and multiple defibrillations in 8 swine with a TEE probe in place. METHODS: We performed TEE on 8 adult swine during CPR and performed multiple 200 J defibrillations with the TEE probe in the mid-esophagus. Post-mortem, esophagi were dissected and inspected for evidence of injury. RESULTS: On macroscopic inspection of 8 esophagi, no evidence of hematoma, thermal injury, or perforation was noted. CONCLUSION: Our study suggests that performing defibrillation during CPR with a TEE probe in place in the mid-esophagus is likely safe and low risk for significant esophageal injury. This further bolsters the use of TEE in CPR and would enable continuous visualization of cardiac activity without the need to remove the TEE probe for defibrillation.
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Traumatismos Abdominais , Reanimação Cardiopulmonar , Parada Cardíaca , Traumatismos Torácicos , Animais , Suínos , Reanimação Cardiopulmonar/efeitos adversos , Parada Cardíaca/etiologia , Parada Cardíaca/terapia , Ecocardiografia Transesofagiana , Esôfago/diagnóstico por imagem , TóraxRESUMO
Tissue flossing (TF) is a novel device that has been shown to cause peripheral compression and concurrent change in joint range of motion, perception of mobility and muscular performance. However, the effect of tissue flossing on pain, perception of mobility and function at the elbow joint has not been thoroughly investigated. The purpose of this pilot study was to examine the acute effect of TF on pain and upper extremity functional performance in subjects with musculoskeletal-related complaints of pain surrounding the elbow joint. We utilized a randomized crossover design. Nine resistance trained participants (8 men/1 woman) mean age 35.6 ± 10.7 took part in this study. We measured the following outcome measures; Pain Visual Analog Scale, Short Form McGill Pain Questionnaire II, pain-pressure threshold and hand grip dynamometry (HHD) pre and post and a Likert scale for movement ability questionnaire, posttest only, following a TF and placebo condition for each participant. TF resulted in significant improvement in all test measures, except HHD, pre to post (p ≤ 0.05). All pre to post changes were associated with large effect sizes for TF compared to the placebo condition applied to the elbow improves pain quality and intensity, perception of mobility and pain-pressure threshold in resistance trained individuals with a history of musculoskeletal pain for greater than 1 month. The results of this pilot study suggest that TF may function as an adjunct to treatment in the management of musculoskeletal pathologies at the elbow joint.
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Studies suggest that internally oriented cognitive processes are central to creativity. Here, we distinguish between intentional and unintentional forms of mind wandering and explore their behavioral and neural correlates. We used a sample of 155 healthy adults from the mind-brain-body dataset, all of whom completed resting-state fMRI scans and trait-level measures of mind wandering. We analyzed intentional and unintentional mind wandering tendencies using self-report measures. Next, we explored the relationship between mind wandering tendencies and creativity, as measured by a divergent thinking task. Finally, we describe patterns of resting-state network connectivity associated with mind wandering, using graph theory analysis. At the behavioral level, results showed a significant positive association between creativity and both intentional and unintentional mind wandering. Neuroimaging analysis revealed higher weighted degree connectivity associated with both forms of mind wandering, implicating core regions of the default network and the left temporal pole. We observed topological connectivity differences within the default network: intentional mind wandering was associated with degree connectivity in posterior regions, whereas unintentional mind wandering showed greater involvement of prefrontal areas. Overall, the findings highlight patterns of resting-state network connectivity associated with intentional and unintentional mind wandering, and provide novel evidence of a link between mind wandering and creativity.
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How prevalent is spontaneous thrombosis in a population containing all sizes of intracranial aneurysms? How can we calibrate computational models of thrombosis based on published data? How does spontaneous thrombosis differ in normo- and hypertensive subjects? We address the first question through a thorough analysis of published datasets that provide spontaneous thrombosis rates across different aneurysm characteristics. This analysis provides data for a subgroup of the general population of aneurysms, namely, those of large and giant size (>10 mm). Based on these observed spontaneous thrombosis rates, our computational modeling platform enables the first in silico observational study of spontaneous thrombosis prevalence across a broader set of aneurysm phenotypes. We generate 109 virtual patients and use a novel approach to calibrate two trigger thresholds: residence time and shear rate, thus addressing the second question. We then address the third question by utilizing this calibrated model to provide new insight into the effects of hypertension on spontaneous thrombosis. We demonstrate how a mechanistic thrombosis model calibrated on an intracranial aneurysm cohort can help estimate spontaneous thrombosis prevalence in a broader aneurysm population. This study is enabled through a fully automatic multi-scale modeling pipeline. We use the clinical spontaneous thrombosis data as an indirect population-level validation of a complex computational modeling framework. Furthermore, our framework allows exploration of the influence of hypertension in spontaneous thrombosis. This lays the foundation for in silico clinical trials of cerebrovascular devices in high-risk populations, e.g., assessing the performance of flow diverters in aneurysms for hypertensive patients.
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BACKGROUND: In hypertrophic cardiomyopathy (HCM), myocyte disarray and microvascular disease (MVD) have been implicated in adverse events, and recent evidence suggests that these may occur early. As novel therapy provides promise for disease modification, detection of phenotype development is an emerging priority. To evaluate their utility as early and disease-specific biomarkers, we measured myocardial microstructure and MVD in 3 HCM groups-overt, either genotype-positive (G+LVH+) or genotype-negative (G-LVH+), and subclinical (G+LVH-) HCM-exploring relationships with electrical changes and genetic substrate. METHODS: This was a multicenter collaboration to study 206 subjects: 101 patients with overt HCM (51 G+LVH+ and 50 G-LVH+), 77 patients with G+LVH-, and 28 matched healthy volunteers. All underwent 12-lead ECG, quantitative perfusion cardiac magnetic resonance imaging (measuring myocardial blood flow, myocardial perfusion reserve, and perfusion defects), and cardiac diffusion tensor imaging measuring fractional anisotropy (lower values expected with more disarray), mean diffusivity (reflecting myocyte packing/interstitial expansion), and second eigenvector angle (measuring sheetlet orientation). RESULTS: Compared with healthy volunteers, patients with overt HCM had evidence of altered microstructure (lower fractional anisotropy, higher mean diffusivity, and higher second eigenvector angle; all P<0.001) and MVD (lower stress myocardial blood flow and myocardial perfusion reserve; both P<0.001). Patients with G-LVH+ were similar to those with G+LVH+ but had elevated second eigenvector angle (P<0.001 after adjustment for left ventricular hypertrophy and fibrosis). In overt disease, perfusion defects were found in all G+ but not all G- patients (100% [51/51] versus 82% [41/50]; P=0.001). Patients with G+LVH- compared with healthy volunteers similarly had altered microstructure, although to a lesser extent (all diffusion tensor imaging parameters; P<0.001), and MVD (reduced stress myocardial blood flow [P=0.015] with perfusion defects in 28% versus 0 healthy volunteers [P=0.002]). Disarray and MVD were independently associated with pathological electrocardiographic abnormalities in both overt and subclinical disease after adjustment for fibrosis and left ventricular hypertrophy (overt: fractional anisotropy: odds ratio for an abnormal ECG, 3.3, P=0.01; stress myocardial blood flow: odds ratio, 2.8, P=0.015; subclinical: fractional anisotropy odds ratio, 4.0, P=0.001; myocardial perfusion reserve odds ratio, 2.2, P=0.049). CONCLUSIONS: Microstructural alteration and MVD occur in overt HCM and are different in G+ and G- patients. Both also occur in the absence of hypertrophy in sarcomeric mutation carriers, in whom changes are associated with electrocardiographic abnormalities. Measurable changes in myocardial microstructure and microvascular function are early-phenotype biomarkers in the emerging era of disease-modifying therapy.
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Cardiomiopatia Hipertrófica , Hipertrofia Ventricular Esquerda , Humanos , Sarcômeros/genética , Imagem de Tensor de Difusão , Predisposição Genética para Doença , Mutação , Cardiomiopatia Hipertrófica/diagnóstico , Fenótipo , Biomarcadores , FibroseRESUMO
Predictive artificial intelligence (AI) systems based on deep learning have been shown to achieve expert-level identification of diseases in multiple medical imaging settings, but can make errors in cases accurately diagnosed by clinicians and vice versa. We developed Complementarity-Driven Deferral to Clinical Workflow (CoDoC), a system that can learn to decide between the opinion of a predictive AI model and a clinical workflow. CoDoC enhances accuracy relative to clinician-only or AI-only baselines in clinical workflows that screen for breast cancer or tuberculosis (TB). For breast cancer screening, compared to double reading with arbitration in a screening program in the UK, CoDoC reduced false positives by 25% at the same false-negative rate, while achieving a 66% reduction in clinician workload. For TB triaging, compared to standalone AI and clinical workflows, CoDoC achieved a 5-15% reduction in false positives at the same false-negative rate for three of five commercially available predictive AI systems. To facilitate the deployment of CoDoC in novel futuristic clinical settings, we present results showing that CoDoC's performance gains are sustained across several axes of variation (imaging modality, clinical setting and predictive AI system) and discuss the limitations of our evaluation and where further validation would be needed. We provide an open-source implementation to encourage further research and application.
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Inteligência Artificial , Triagem , Reprodutibilidade dos Testes , Fluxo de Trabalho , HumanosRESUMO
The mechanisms by which the lipid droplet (LD) membrane is remodeled in concert with the activation of lipolysis incorporate a complex interplay of proteins, phospholipids, and neutral lipids. Model LDs (mLDs) provide an isolated, purified system for testing the mechanisms by which the droplet composition, size, shape, and tension affects triglyceride metabolism. Described here are methods of making and testing mLDs ranging from 0.1 to 40 µm diameter with known composition. Methods are described for imaging mLDs with high-resolution microscopy during buffer exchanges for the measurement of membrane binding, diffusion, and tension via fluorescence correlation spectroscopy (FCS), fluorescence recovery after photobleaching (FRAP), fluorescence lifetime imaging microscopy (FLIM), atomic force microscopy (AFM), pendant droplet tensiometry, and imaging flow cytometry. These complementary, cross-validating methods of measuring LD membrane behavior reveal the interplay of biophysical processes in triglyceride metabolism.